Does a threshold in the consumption of alcoholic beverages exist to minimise risk?
The current study used data from the UK Biobank to carry out a prospective analysis of the relationship between the consumption of different types of alcoholic beverages and the risk of all-cause mortality, cardiovascular disease (CVD) and chronic kidney disease (CKD).
Drinking alcoholic beverages, a significant aspect of the global food culture, has been integrated into people’s daily lives and affects their physical well-beings. While recent years have seen notable progress in understanding the effect of drinking on adverse health outcomes, research findings have been inconsistent, and the overall quality of evidence remains limited. Some researchers have reported that there is no clear safe level of alcohol consumption, even light to moderate drinking poses health risks. However, others believe that only excessive alcohol consumption is correlated with an increased risk of various adverse health outcomes.
The purpose of this study was to identify the thresholds where the consumption of alcoholic beverages not only protects against all-cause mortality, CVD, and CKD, but also does not increase the risk of other major adverse health outcomes.
The average weekly consumption of red wine, champagne plus white wine, beer, spirits, and fortified wine was assessed via questionnaire and during almost 12 years of follow-up, the all-cause mortality and occurrence of CVD and CKD was recorded. The study participants were divided into 4 alcohol consumption categories (no consumption of alcohol, mild drinking, moderate drinking, and severe drinking *).
The results showed that total the consumption of alcoholic beverages was inversely associated with the risk of CKD, whereas the association between total alcohol consumption and the risk of CVD and all-cause mortality was U-shaped.
Safe level or threshold
Consumption of red wine, champagne plus white wine, beer, and fortified wine below the corresponding thresholds were associated with a significantly lower risk of all-cause mortality, CVD, and CKD. According to this study, the safe doses of total alcohol consumption (125 ml/glass) should be:
- < 11g/d for males and < 10 g/d for females,
- red wine consumption should be < 7 glasses**/week for males and < 6 for females, or
- champagne plus white wine consumption should be < 5 glasses/week, or
- fortified wine consumption should be < 4 glasses/week.
These alcoholic beverages consumed in the above doses exhibited a protective effect against conditions like diabetes, depression, dementia, epilepsy, liver cirrhosis, and other digestive diseases, and did not increase the risk of cancer.
(*) No consumption of alcohol: 0 g alcohol intake; mild drinking: 0–5 g; moderate drinking: 5–15 g for female, 5–30 g for male; severe drinking: > 15 g for female, > 30 g for male
(**) 125ml/glass
Possible mechanisms
As possible explanation/mechanisms, the authors explained that natural differences in different types of alcoholic beverages may account for the differences in their impact on adverse health outcomes. Grape polyphenols may be the main components that contribute to the health benefits of moderate wine intake. Several mechanisms could explain the protective effects of polyphenols on human health:
- the polyphenols of red wine play a crucial role as antioxidants.
- light to moderate alcohol intake may be anti-inflammatory, non-alcoholic compounds of white wine such as tyrosol and caffeic acid could mitigate inflammatory reactions and oxidative stress.
- cytoprotection (cell protection) may be another potential protective factor. The content of phenolic compounds in champagne is relatively high, such as gallic acid, protocatechuic acid, tyrosol, and caffeic acid, which may play a role in protecting cells in the body. In addition, red wine polyphenol significantly increases the abundance of bacteria that are known to promote gastrointestinal health.
The authors concluded that these findings offer an update on current recommendations, suggesting that individuals should moderate their consumption according to the type of alcoholic beverage as part of a healthy lifestyle.
